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South Dakota rates for HCPCS 97158

Group adaptive behavior treatment with protocol modification, administered by physician or other qualified health care professional, face-to-face with multiple patients, each 15 minutes

Facilitymedian $4 · 10th–90th $3–$190%20%10th90th$4Professionalmedian $19 · 10th–90th $4–$200%50%10th90th$19$5.0$10.0$20.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.02 / $3.02 / $3.02
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.02 / $19.05 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $12.02 / $13.80
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.72 / $19.05 / $32.36
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $11.75 / $40.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.61 / $7.76 / $7.76
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $11.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.50 / $10.00 / $13.80
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $9.55 / $9.55